Case Study: Billing

Finding $171,000 lost in the couch: How a typical human service agency lost money due to staff turnover and let AWARDS help turn the loss into a windfall.

Organization Type: Mental Health and Homeless Services Agency
Total staff: 200
Annual Operating Budget: $15 million

The Standard: Tracking clinical data using AWARDS

An agency which provides mental health services and housing for the homeless had difficulty keeping track of its Medicaid billing, especially re-billing for services that lacked complete documentation. Using AWARDS, they were able to closely monitor direct care staff to ensure that services were appropriately documented and identify programs where documentation was incomplete.

AWARDS’ billing system tracks required documentation, including timely completion of service plans and service plan linked progress notes that contain all of the elements necessary to bill. The agency began using AWARDS’ billing system, and now report billing successfully for over 95% of their services.

The Next Step: Using AWARDS to bill for services

The agency called on its Senior Project Manager to assist in identifying services that were provided and never billed, due to staff turnover. In addition, staff in one program had trouble keeping up with service documentation prior to using AWARDS and had some services that had previously been denied. 

The Result: More money, more services, no fear of an audit

In a letter of thanks to the staff at Foothold for this effort, their CFO wrote: "On behalf of myself, and [my agency’s] staff, I would like to sincerely thank you for helping us to collect $171,000 from Medicaid re-billing payments. This has been an incredible help, to not only the staff at the agency, but also the consumers that we serve." Along the same lines, a second executive director recently reported, “thanks to AWARDS we received a perfect score on the agency audit with the Medicaid Inspector General – I didn’t even know that was possible.”